Provider Demographics
NPI:1245473818
Name:HOLISTIC HOME HEALTH CARE CORP
Entity type:Organization
Organization Name:HOLISTIC HOME HEALTH CARE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:ROBERTO
Authorized Official - Last Name:SOARES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-965-9103
Mailing Address - Street 1:7950 W FLAGLER ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2206
Mailing Address - Country:US
Mailing Address - Phone:786-528-5252
Mailing Address - Fax:786-360-3957
Practice Address - Street 1:7950 W FLAGLER ST
Practice Address - Street 2:SUITE 105
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2206
Practice Address - Country:US
Practice Address - Phone:786-528-5252
Practice Address - Fax:786-360-3957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-13
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherEMPLOYER IDENTIFICATION NUMBER